In honor of teething week on my Instagram, I welcome Dr. Erin Isaac, Pediatric Dentist and @dr_erin on Instagram.

We have a great discussion about Pediatric Dental Health. We discuss:

• When should babies see the dentist?
• What is typically done at these early visits?
• When should a parent start brushing and flossing and how?
• Is fluoride okay? What if there is fluoride in drinking water?
• What are risk factors for developing cavities?
• What do you do if a tooth falls out?
• How can a parent prep their child for a dentist visit?
• How can a parent help the dentist do their job as seamlessly as possible?

00;00;06;11 – 00;00;36;17

Dr. Mona

Hey, everyone. Welcome to the PedsDocTalk podcast. I’m your host, Doctor Mona, where each week I hope to educate and inspire you in your journey through parenthood with information on your most common concerns as a parent and interviews with fellow parents and experts in the field. My hope is you leave each week feeling more educated, confident, and empowered in decisions you make for your child.

 

00;00;36;19 – 00;00;54;16

Dr. Mona

Hello! Welcome to this week’s episode where I have Doctor Erin, who owns her own pediatric dental practice in Pittsburgh and has her own Instagram as well. Doctor underscore Erin. And she’s joining me today so that we can chat about dental health for your children. Thank you for joining me, doctor. Erin.

 

00;00;54;19 – 00;00;56;14

Dr. Erin Isaac

Hi. Thank you for having me.

 

00;00;56;21 – 00;01;05;06

Dr. Mona

So first, tell me a little bit about yourself. Obviously, you own your own private practice where that’s at, what you do and why you love being a pediatric dentist.

 

00;01;05;09 – 00;01;26;01

Dr. Erin Isaac

Sure. Yeah. So I, as you said, I’m located in Pittsburgh, right in the middle of the city and the shady side area, if anyone’s familiar. I own a boutique pediatric dental practice. So boutique, meaning that we really focus on each and every kid and really take our time with each and every kid. Very individualized. Not very overwhelming.

 

00;01;26;01 – 00;01;48;24

Dr. Erin Isaac

With tons of families in the office all at once. So it makes for a really calm, positive experience for the kids. Yes, I own that office. And I just love, love, love being a pediatric. It’s so much fun. Kids are amazing, and they just make the day so exciting because you never know what they’re going to get with it.

 

00;01;48;24 – 00;02;09;26

Dr. Erin Isaac

So that it always makes it so much fun. They’re just such a bright ray of sunshine and all of the craziness that can be going on. So I love it, and they’re just so fresh and eager to please usually. And, really easy to kind of mold and shape and soak in all the info, and obviously a kid friendly way.

 

00;02;09;26 – 00;02;11;23

Dr. Erin Isaac

So it’s just really, really fun.

 

00;02;11;25 – 00;02;31;20

Dr. Mona

I agree with you completely that they are amazing. Obviously, I’m on the other side as a physician. And, you know, obviously I’m very happy that we can do this today. It’s funny, as a general pediatrician, the one thing I don’t do is teeth, right? So families will come in and they’ll say, well, doctor, can you take a look at my child’s molar or something?

 

00;02;31;20 – 00;02;52;15

Dr. Mona

And I’m like, I could, but I’m not trained in that. There’s actually a completely different specialty for your teeth. And it’s so funny because we deal with every other part of the body. And I people, parents are always confused why I can’t do an exam on their teeth. And I tell them it’s a whole different school. And so I’m really happy that we can talk about this.

 

00;02;52;16 – 00;02;56;06

Dr. Mona

I’ll talk about everything. Pediatric dentist dentistry today. Thank you.

 

00;02;56;08 – 00;03;17;09

Dr. Erin Isaac

Absolutely. Yeah. It’s so funny because my one of my sisters is a pediatrician. So I know firsthand that, she gets those questions all the time. And we always say that pediatric dentists are like the pediatricians of the mouth. There’s a reason why there’s a specialty just for kids teeth. So I’m so happy to be here today and share some of that up.

 

00;03;17;12 – 00;03;24;09

Dr. Mona

Awesome. So yeah, the first question that I obviously get is when should a parent take their child to the dentist? How early?

 

00;03;24;11 – 00;03;47;26

Dr. Erin Isaac

Yeah. So our recommendation from that I follow from the American Academy of Pediatrics. Dentistry is either within six months of their first teeth coming in or by age one. So we really want to get them in nice and early so that they are getting used to coming to the dentist regularly, and then also just making sure that everything is growing and developing.

 

00;03;47;26 – 00;04;11;01

Dr. Erin Isaac

Okay. Answering any questions that parents have, going over toothbrushing techniques and, I had a nutrition advice, so it really does start early, as you said. You know, that’s just how schooling is. And med school, you don’t get a lot, or even a pediatric residency for, physicians. You don’t get a lot of medical stuff.

 

00;04;11;04 – 00;04;16;28

Dr. Erin Isaac

So we are the ones who are going to be able to give the parents that needed information.

 

00;04;17;00 – 00;04;25;12

Dr. Mona

And how often would a child come just say, you know, they come at one year. How often would you recommend them coming to the dentist after that one year mark?

 

00;04;25;15 – 00;04;47;25

Dr. Erin Isaac

Every six months, just like us adults are supposed to do, especially for kids, because they are growing and changing so rapidly. We want to make sure that all these changes are within normal and that they’re getting, specific teeth at certain times and that they’re coming in, you know, kind of in the right way. So we want to make sure that they are every six months.

 

00;04;47;27 – 00;05;09;22

Dr. Mona

Awesome. And obviously the visits are important, like you said, for education, because a lot of my family is, you know, at the sixth or at the one year mark, they’re like, well, doctor, what are they really going to be doing there? I’m like, well, they do a lot of education and they just get you comfortable with brushing your child’s teeth with why it’s important with a little more than what we can do as general pediatrician.

 

00;05;09;22 – 00;05;26;05

Dr. Mona

So I agree it is it is an important thing to start to see the dentist. But when, they go to the dentist, obviously you’re going to give them the education. When should the parents start to brush the child’s teeth? Obviously just say that they’re waiting until one to come to you guys. When should they start to brush or floss?

 

00;05;26;05 – 00;06;00;23

Dr. Erin Isaac

Even so, brushing quote unquote technically should happen even before teeth come in. You want to use a force or a wet washcloth and kind of just rub over those, mostly so that, the kids are getting used to having fingers and hands in their mouth. But then as soon as you come in, you want to start actually brushing them, using either one of those silicone finger brushes or, a regular toothbrush, a very small toothbrush, brushing those teeth as soon as they come.

 

00;06;00;23 – 00;06;24;16

Dr. Erin Isaac

And, we usually don’t start using toothpaste until about one year old, but start brushing those teeth, because as soon as you come in, the bacteria that like to cause cavities, love hard tissue. So they’re going to cling right on to the teeth as soon as those things come in. And there’s no cut off aid for when cavities can start as soon as they come in.

 

00;06;24;18 – 00;06;31;04

Dr. Erin Isaac

Cavities can form if we’re not taking care of them. So it’s really important to start brushing right away, actually.

 

00;06;31;07 – 00;06;47;26

Dr. Mona

And is there certain brands of toothpaste that dentists recommend? I’m sure people see all the commercials and I doubt that’s really real. But in terms of as a pediatric dentist, do you have any sort of recommendation on brands or how much toothpaste to use? You know, obviously when they start to begin to use it?

 

00;06;47;28 – 00;07;08;11

Dr. Erin Isaac

Yeah. So I don’t have a particular brand recommendation for, say, my concern more so is and I know this is the hot topic and that we’ll probably get into a little bit later, but, at age one, we really do want to start using a fluoride based toothpaste, because fluoride. Here’s the thing. It’s a naturally occurring mineral.

 

00;07;08;18 – 00;07;33;22

Dr. Erin Isaac

And when teeth come in, they’re not completely mineralized or hardened all the way. So we actually want to kind of take advantage of that input in this additional fluoride to help strengthen those teeth. Now, at 81, we’re literally only using a tiny little smear the size of a grain of rice. That is it. Whether you decide to use a fluoride based toothpaste or not, that’s all you should be using.

 

00;07;34;03 – 00;07;56;00

Dr. Erin Isaac

So then in that case, if and when they swallow a bit of it, it’s really, really, really not a big issue because we’re using such a small amount, yet some are still contacting us to help the strength of them. So brand wise is not a really big deal. Just make you drink that fluoride in. And then I think you could also ask about flossing when we should do that.

 

00;07;56;08 – 00;08;19;14

Dr. Erin Isaac

Flossing should occur. Right. When teeth touch. So as more and more teeth come in, you want to try to get some floss in there. You can even use this little floss. There’s this little floss sticks. And get, that floss in between there. It’s not going to be perfect. Is brushing going to be perfect? Now the goal is to at least attempt and try to do these things to help to keep the kids healthy.

 

00;08;19;16 – 00;08;40;10

Dr. Mona

Yeah. And at the end of this conversation, we will talk about ways to hopefully help your child at home and also at the dentist to help them with that habit of brushing, but talking a little bit more about fluoride. I agree with you that there is a lot of fluoride fear. You know, parents in when they come to our office, we actually do fluoride varnish, which I’m sure you guys do as well.

 

00;08;40;14 – 00;08;58;01

Dr. Mona

And for any of you who are not familiar with that, it’s basically what she’s describing, that sort of small amount of, of that fluoride paste that we put on the mouth, so on the teeth. And we do that every six months in our pediatric offices until they see the dentist. And, you know, I do recommend it.

 

00;08;58;01 – 00;09;10;02

Dr. Mona

It’s it’s obviously fine to use safety wise. I mean, obviously fluoride from your from the pediatric standpoint, from the AP, but also from the, pediatric dentistry standpoint. Safety is okay. Correct?

 

00;09;10;04 – 00;09;33;18

Dr. Erin Isaac

Yes, absolutely. Like I said, fluoride is a naturally occurring mineral. And just like anything out there, you can have too much of a good thing. So that’s why we recommend that you stick to these guidelines that we’re telling you. And then in that case, it will benefit the kid and they’ll actually it’ll be fine if a little bit all it as long as you’re within those guidelines doesn’t matter.

 

00;09;33;18 – 00;09;47;02

Dr. Mona

If so, you know, some communities have fluoride in their water, some don’t. You know, if they’re using well water or whatever it may be, does it matter whether there’s fluoride in the water? And then adding on that dent, the amount that you get into paste or. No, it’s a small.

 

00;09;47;02 – 00;10;09;25

Dr. Erin Isaac

So that’s a great question. So there’s been lots of studies. And the recommended amount actually amount takes into account that most places you have fluoride in the water. So still using that amount that we recommend that, size of a grain of rice for about 1 to 3 years old, 3 to 6, and use a pea sized amount.

 

00;10;10;08 – 00;10;34;07

Dr. Erin Isaac

And that kind of takes into account that most places do have fluoride in the water. Now, there are still areas around that don’t have fluoride in their water. And, a lot of pediatric dentists, still do, or at least used to recommend, like fluoride drops, adding to their water or fluoride supplement. But in my case, I found that they using a fluoride toothpaste.

 

00;10;34;29 – 00;11;05;13

Dr. Erin Isaac

And when they get old enough using a fluoride ordinance, even without having fluoride in the water that we know of, it’s usually enough to protect those teeth because fluoride in fluoride is naturally occurring. So you’re probably up in other places if you have a frozen meal, and you just throw into the oven or the microwave that’s probably been cooked previously with for passport and it like we’re picking it up from all other places, it occurs in some tea leaves and things like that.

 

00;11;05;13 – 00;11;10;23

Dr. Erin Isaac

So we’re always picking it up little pieces. But that little amount is fine.

 

00;11;10;25 – 00;11;27;20

Dr. Mona

Good. I want to go to the comment you said about cavities. Is there anything that predisposes a child to get cavities? Obviously behaviors at the family may doing genetics. And you know, in your, in your expertise, is there anything that is preventative for cavities.

 

00;11;27;22 – 00;11;56;07

Dr. Erin Isaac

Sure. So that is a very good question. Actually, I would say the smallest component of getting cavities is the genetic side of things. And when I say genetics, I’m talking more so about potentially the type of bacteria that you have in your mouth, but more so, dos structure, like if you have a tiny little dot in your teeth are going to be very crowded or overlap, which can lend to not being able to get down in there and get the bacteria out from in between those teeth.

 

00;11;56;09 – 00;12;24;25

Dr. Erin Isaac

So that’s more so the genetic portion of it. But the bigger things come from what we’re eating and drinking and how we’re taking care of our teeth. So obviously what we already mentioned going to the dentist twice a year, every six months, getting that fluoride varnish. And that helps to if we see something small starting, we can do other preventative type of things to really help that from getting larger or becoming an issue.

 

00;12;25;20 – 00;12;51;04

Dr. Erin Isaac

So there’s that portion. And then like we said, talking about our eating and drinking at home, obviously, we all know to minimize the amount of sugars that our kids are eating and drinking. But the thing that I harp on the most at my office are the liquid versions of sugars, juices, and the chocolate milks and iced teas, flavored iced teas, and anything that can really get in those blocks and crannies.

 

00;12;51;06 – 00;13;19;25

Dr. Erin Isaac

That’s what’s going to give you the new stuff. And I mean you guys, it recommends that kids under one shouldn’t even be having juice anyway. But, you know, that happens a lot. So really just keeping those down can help to prevent cavities a lot. Water and white milk or almond milk if the kids are, you know, lactose intolerant or allergic to milk are going to be think or partly.

 

00;13;19;27 – 00;13;45;14

Dr. Mona

Yeah. And, you know, as obviously in my office, I see a lot of parents with, you know, they’ll be popping the bottle in, you know, the baby’s bottle, whether it’s formula or, obviously juices. Like you said, I agree that the American Academy of Pediatrics and even myself really like to limit a lot of sugary drinks, and I just say, don’t even offer it in the first place, because if they don’t ever tasted it, they won’t ever miss it.

 

00;13;45;14 – 00;13;46;17

Dr. Erin Isaac

So, exactly.

 

00;13;46;19 – 00;13;54;07

Dr. Mona

From the beginning, it’s a little, little sign from the pediatric dentist and the general pediatrician just don’t introduce sugary drinks if they have. No, they don’t.

 

00;13;54;07 – 00;13;55;07

Dr. Erin Isaac

Know what they’re missing.

 

00;13;55;07 – 00;14;21;21

Dr. Mona

Yeah, there’s just no nutritional value. It’s just not good for our teeth. Maybe as they get older, if you decide to do it as like a treat basis in terms of a party. But I agree with that concept for dental health and just overall medical health, because sugar drinks just have no, no utility for us. So I wanted to ask, you know, one of the common things is how do I get my toddler, my, you know, the toddler that’s flailing their arms around?

 

00;14;21;28 – 00;14;28;25

Dr. Mona

How can I show them how to brush or help them brush? Should I pin them down? What are my options and what would you recommend?

 

00;14;28;27 – 00;15;00;19

Dr. Erin Isaac

So so it gets tricky because every child is different. So there are some one and two year olds who literally will just open wide and let you get in. There is it the norm? No, it doesn’t happen. But for the most part, I would say the biggest thing is modeling. So if they have an older sibling that they adore, have that older sibling brushing alongside of them so that the, so that your little one, your toddler can see, oh, this is like a normal thing.

 

00;15;00;19 – 00;15;26;01

Dr. Erin Isaac

Everyone does this, or even you as a parent, you know, they’re going to probably do what you do. They’re going to want to try it. So I recommend that first, having someone, kind of show them like, what I’m brushing do and then they can a little one can kind of do or unquote their brushing, which is probably going to be mostly chocolate doing on the toothbrush.

 

00;15;26;07 – 00;15;48;22

Dr. Erin Isaac

And then the parents can kind of go over top of it. If that doesn’t work, I like to also recommend try to brush, coming from behind or from the side of the kids. So instead of standing face to face with them and kind of dabbing the toothbrush in their mouth come from behind or the side, almost like you’re giving them a little side hug.

 

00;15;49;05 – 00;16;08;03

Dr. Erin Isaac

And then, your one hour kind of wrapping around them, and then the arm with the toothbrush coming around from behind or beside. And that usually gives a much better angle to get in there singing the song while you’re doing it or having, something playing on YouTube that they can watch while you’re doing it. It’s really fun.

 

00;16;08;03 – 00;16;33;18

Dr. Erin Isaac

There’s all kinds of apps from I think Colgate has a really fun app. That’s two minutes long, that has songs that can help you help the kids kind of be distracted at two minutes of brushing and, that doesn’t work. Then I recommend trying in the bathtub when they’re already getting other stuff done. A lot of kids really like brushing in the tub when they’re already, you know, getting cleaned up.

 

00;16;33;18 – 00;16;57;26

Dr. Erin Isaac

Anyway, try brushing in there. You can also try, a sitting Indian style with your child on top of your up and your legs kind of over top of their wiggly legs and again, have their head kind of cradled almost in your shoulder, or like underarm armpit area, giving them a gentle hug with one arm and then bringing that toothbrush around again.

 

00;16;57;26 – 00;17;20;23

Dr. Erin Isaac

That’s kind of on the back of the side and that is that angle in there. So it’s not really killing them down per se, but it is just keeping those arms and legs from all over the place. Usually one of those will work, even, laying laying them kind of on a bed or on a chair, kind of, almost in a neat any position.

 

00;17;20;23 – 00;17;40;22

Dr. Erin Isaac

You can even try having your partner, your spouse, you know, and laying, the kiddo back into their lap and then having, the one who has the head in their lap get the toothbrush in the mouth. That actually helps a lot, because that’s kind of how we do it at the office.

 

00;17;40;25 – 00;18;08;07

Dr. Mona

I agree, you know, I’m happy because I obviously don’t love the pinning down method to brush teeth. I just I’ve heard exactly. And I know if you are listening and you’ve done this, done the pin down method, I’m not saying that you’re this is an awful thing, but it can be scary, obviously. And if the if you’re doing all those methods that doctor Aaron said, which I think are beautiful and they’re just resistant to it, you keep repeating and trying and trying and trying until they do one of those methods, right.

 

00;18;08;07 – 00;18;27;27

Dr. Mona

It’s not worth it to scare them to the point of pinning them down. And, you know, like a, like a, like a scary thing because it’s just not worth that sort of break of trust. And I agree, it’s your if you miss 1 or 2, the fact that you’re just repeating and giving it a shot every day. And you recommend obviously you said twice a day, right.

 

00;18;27;27 – 00;18;28;21

Dr. Mona

Brushing.

 

00;18;28;23 – 00;18;58;03

Dr. Erin Isaac

Yes. Yep, yep. I recommend at least trying twice a day. But like you said, I agree you have to keep trying and you can try different methods each time. One day they might respond to one thing and next day they hate it. So you try a different method. That’s the key is to try not to make it scary, but keep doing it so that they realize this is something that we kind of have to do and that we’re going to do, and that will help prevent cavities, which could be more scary than brushing teeth.

 

00;18;58;03 – 00;19;17;21

Dr. Mona

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00;19;17;24 – 00;19;37;29

Dr. Mona

If you follow me on Instagram at Pete’s Dog Talk, you’ll see Ryan in their adorable footie pajamas. We’ve been buying them since Ryan was a newborn and continue to buy them as he grows. And we love the rompers for daywear, and they were nice enough to pass along a special discount to all of you. You can use Code Pete’s doc 15 at checkout to save 15% off your first order.

 

00;19;38;04 – 00;20;00;12

Dr. Mona

Go to Lark Adventure wear.com to shop and link is available in my show notes. And you know the motto that I have for parenting. And we’ve spoken about this, patience and persistence. Right. And that goes with everything that you’ll do, right? Potty training, introduction of solids like food, eating, obviously brushing. Obviously being patient in the sense that it’s not going to happen tomorrow.

 

00;20;00;13 – 00;20;18;06

Dr. Mona

It may not. It’s awesome if it does. And the persistence that, hey, if they don’t do it, you keep trying and it’s you’re going to feel like a broken record as a parent. It’s unfortunately the reality of parenting. And I think from my perspective in my office, people give up with the brushing because they’re like, well, my child doesn’t like it.

 

00;20;18;06 – 00;20;38;23

Dr. Mona

I’m like, well, they don’t like it because it’s new and it’s different. But if you model behavior like you said, it’ll happen. I use the example of like when I give like baths, right? Kids will freak out with baths like initially, but if you just control your facial expressions when it’s happening, as a parent, you don’t get scared like, oh my god, you’re excited.

 

00;20;38;28 – 00;20;42;27

Dr. Mona

Smile, smile and say it’s okay. And so it right.

 

00;20;42;27 – 00;20;44;29

Dr. Erin Isaac

And then that laugh and thing.

 

00;20;45;02 – 00;21;06;02

Dr. Mona

Yeah, exactly. It’s exactly that. And I think, you know, whether it’s brushing or any sort of activity you need your child to do, having a positive face as a parent and being patient and repetitious with that behavior, it’ll go a long way. So I love it because people it doesn’t have to be the struggle. And I think that’s what parents get into, the sort of power struggle.

 

00;21;06;02 – 00;21;25;01

Dr. Mona

And it does not have to be at all. So absolutely love that. Now, one other common question I get is and they’ll come to us and I’m like, okay, I’m a general pediatrician. I’m not your dentist. What do you do to kind of parts? But first is what to do if the tooth if a tooth falls out, you know, where do I go?

 

00;21;25;01 – 00;21;30;19

Dr. Mona

Do I need to put it in milk, like all these things that they’ve heard? So what would be your recommendation if you know of tooth falls out?

 

00;21;30;21 – 00;21;54;15

Dr. Erin Isaac

Okay, sure. So we have to first consider is it a baby tooth for an adult to, if they are five six, then there’s a very good chance that, that was a loose two. Anyway, a baby tooth that was on its way out, naturally. And that the adult tooth is wanting to come and that’s about we still say the average age is about six when adopted.

 

00;21;54;26 – 00;22;23;19

Dr. Erin Isaac

In, you know, people think kids have grown younger getting adult teeth and, but I would still say the average age is about six. So if it’s a baby tooth that was naturally wanting to fall out anyway out of the, you know, now, if they are two three and that tooth got knocked out from maybe a head from another little other friend, or they fell and hit, their mouth off the coffee table and a baby tooth pops out.

 

00;22;23;21 – 00;22;52;15

Dr. Erin Isaac

But baby, do we any teeth? I should say we do not re implant those. The issue becomes that if we try to shove that baby tooth back down in there, then you can actually severely damage the adult tooth that’s growing, underneath it. So, so if a baby tooth does come out or, you know, you’re just concerned as if that baby tooth wasn’t adopted, I don’t know, contact your pediatric dentist.

 

00;22;52;17 – 00;23;13;14

Dr. Erin Isaac

And I know that I do virtual consults. I actually just started doing virtual consults. So you can actually send a picture. And I can record a response and let you know. Oh, that looks like that. The baby. Here’s what to do. Usually in that case of a baby tooth that’s coming out early, like around two or so, I get there’s not much to do.

 

00;23;13;14 – 00;23;33;23

Dr. Erin Isaac

We’re not going to put it back in, but, the kids are just going to have to kind of take it easy in that area as far as eating soft foods and not trying to mess around area too much. Now, if they’re eight, nine, ten, and then I got an adult to a completely different story that needs to go into milk.

 

00;23;34;26 – 00;24;01;07

Dr. Erin Isaac

If you don’t have milk, say you’re out at the soccer field. There’s this thing called Hank’s, our salt solution, which sometimes, arenas and, you know, fields, playing fields will have a lot of Pepsi. So if all else fails, this is going to sound really gross, but I try to gently bury gently, just wipe off the top part of the tooth like you actually normally see in the mouth.

 

00;24;01;09 – 00;24;22;23

Dr. Erin Isaac

And then if you have nothing else, put it in, put it either in your mouth or in the kit, like literally just sitting there, enough so that it stays wet with, saliva. Water is my last recommendation that can actually accelerate kind of, like kind of the tooth. So I’d rather it be sitting in someone’s mouth.

 

00;24;22;23 – 00;24;51;29

Dr. Erin Isaac

I know it sounds gross, especially if it was like in the middle of a muddy soccer field, but, you know, fall us well, that’s. What do you have? If you can’t re implant it, ideally, we would try to find that tooth and adopt it and put it up in that socket. But if you’re not able to have it sit in, your cheek or their kids, you can say to a hospital or, your pediatric that this who can, then that’s it for you.

 

00;24;52;16 – 00;25;21;13

Dr. Erin Isaac

The big thing is time with that. So after about an hour, you get really into that point where, this probably isn’t going to fare very well. Now, I still typically try to re implant it, even if it’s after an hour. But the, the longevity of staying in there, you know, when goes with every passing minute after an hour or so, it’s really an urgency to get to the hospital or get to your pediatric dentist.

 

00;25;21;14 – 00;25;39;04

Dr. Mona

Okay. And the second portion I had was, like you’d kind of mentioned, like, if you like, on a coffee table or there’s like a trip and fall and the tooth doesn’t, the tooth doesn’t get knocked out. But basically they, they hit their lip, obviously causing a little trauma to the tooth. And then there ends up being some discoloration.

 

00;25;39;07 – 00;25;48;17

Dr. Mona

Do they need to see the dentist? You know, what would be the kind of follow up with that is their X-rays? What is kind of the the, you know, outlook for discoloration after a trauma?

 

00;25;48;17 – 00;26;09;15

Dr. Erin Isaac

Sure. I actually just had this last night and, one of my patients, the mom, did a cardio consult with me and were able to figure it out that way. But I would say, if you see it wiggle ING a little bit, a lot of times that tooth will get a little bit wiggly after obviously a trauma like that.

 

00;26;09;27 – 00;26;40;05

Dr. Erin Isaac

And then potentially down the line, it can discolor. Now, discoloration in and of itself is not an issue. It’s discoloration along with, severe pain or swelling or an abscess that ends up being an issue. But nonetheless, if and when you see that discoloration, definitely give your pediatric dentist a call. We’ll figure out if you need to come in, if there’s any X-rays that we need to do, you know, is two were really young.

 

00;26;40;05 – 00;27;10;29

Dr. Erin Isaac

It’s very, very difficult, almost impossible to get X-rays on them at that point. So we often kind of use, a triage system and play it by ear, continue to monitor, because there’s not much you can do about the discoloration. It’s almost like a bruise on the tooth. But we always want you to follow up with your pediatric dentist so that we can have kind of like a baseline, and then we can keep our eye on it for every six months when they come in.

 

00;27;10;29 – 00;27;34;02

Dr. Erin Isaac

For there is, you know, we can tell. Are the gums getting red and irritated and puffy? Is this tooth really super loose still, even a year down the line? I think the big thing is just following up with your pediatric dentist and not panicking because the discoloration is, I don’t want to say normal. That happens a lot with the trauma.

 

00;27;34;04 – 00;27;43;02

Dr. Erin Isaac

And a lot of times, like I said, there’s nothing to do about it and that will be just fine until it falls out, actually. But just following up with the pediatric, did.

 

00;27;43;05 – 00;27;55;00

Dr. Mona

You said something about X-rays? And I’m going to go back to another question. So people have a lot of families have fluoride fear and they also have a fear of accidents. How often do you do X-rays as a pediatric dentist? Is it on a routine basis?

 

00;27;55;14 – 00;28;29;08

Dr. Erin Isaac

So everyone does it a little bit differently. But in my office, our baseline is about when back adult molars start to come in, which is about six years old. Is when we, really start thinking about taking those inside of the mouth. X-rays or spike wing X-rays, we call them. Now, there are plenty of kids who we take X-rays sooner than that, that either one have really tight spaces or tight teeth in their context, we call them, and I can’t literally see all around the tooth to ensure that there’s no cavity because the teeth are just sitting right up against each other.

 

00;28;29;13 – 00;28;59;10

Dr. Erin Isaac

So sometimes I’ll take X-rays as young as four and a half if I’m not able to see in between those teeth. And, you know, I might be concerned that there’s something going on in between those teeth. Also, kids who are younger than six or so without adult teeth in there, if obviously I see a black spot or a brown spot or something that looks indicative of dental, the K that I’m going to try to take an X-ray if I feel like they can handle taking one in an office.

 

00;28;59;24 – 00;29;31;06

Dr. Erin Isaac

Obviously, you know, adults have a time getting those X-rays done. So, we always kind of just, touch based on individual child. And then, of course, if they come in after a trauma, we’re going to want to get, x rays again. If they’re, if we can handle getting that X-ray, if they’re due, and we think that there’s no way we’re going to be able to get in there, do we have to use our best professional judgment as to what’s going on at the, estimate from there?

 

00;29;31;08 – 00;29;55;06

Dr. Mona

So obviously, you as a pediatric dentist do a lot of procedural activity, right? Obviously, you’re in the child, you’re teaching you are using many different, obviously necessary tools to do your job. How, you know, now we’re going to get into this kind of this kind of segment where we’re talking about how parents can help us as a dentist and pediatrician do our job.

 

00;29;55;12 – 00;30;00;25

Dr. Mona

So what can a parent do in the office to help you do your job?

 

00;30;00;27 – 00;30;24;20

Dr. Erin Isaac

So the biggest thing well, one of the biggest things I would say is preparation and using positive words to prep the kids. I hate going to the dentist too, but we just have to do it. It’s not positive. More of, oh, this is the doctor for your mouth. We’re going to count and we’re going to check, and we’re going to brush, you know, using positive words.

 

00;30;24;27 – 00;30;51;16

Dr. Erin Isaac

Set your child up for going in there and having a great experience. Now, if it’s for a procedure, as in, like getting a filling taken care of or things like that, my, biggest suggestion would be if you don’t know how to prepare your child and they’re asking you questions, seriously, give your pediatric dentist a call and we’ll tell you how to explain it to them, because we don’t want to say, oh, you’re not going to get sleepy.

 

00;30;51;16 – 00;31;09;17

Dr. Erin Isaac

Geez. We call it for the numbing medicine. And then I ended up having to get them sleep juice. And they’re freaking out because I’m would lie to them, you know? So, definitely give us a call if you don’t know how to explain it, but, positivity is going to be the best thing, and, it depends on your child.

 

00;31;09;17 – 00;31;34;11

Dr. Erin Isaac

Some kids like more details. Some kids don’t. You know your child the best as to if they be better with knowing the details or if they do best with, oh, we’re just going to go visit doctor and she’s just going to brush. And some kids are like, okay, great. So, you know, your child, but I think you can even there’s a great, really, really good Daniel Tiger episode about going to the dentist.

 

00;31;34;17 – 00;31;59;25

Dr. Erin Isaac

And that is spot on. Like, it is actually pretty amazing how fast it is. So I highly recommend doing videos like that. I think first one with Peppa Pig. Also when she goes to the dentist, there’s so many books out there that you can use to prep. Like I said, even if you don’t like going to the dentist, don’t show that fear or anxiety to your kid because they pick up on that in a heartbeat.

 

00;32;01;03 – 00;32;08;05

Dr. Erin Isaac

So use these tools to help you explain and get them prepared positively or for their experience.

 

00;32;08;07 – 00;32;28;27

Dr. Mona

And also our anxieties definitely go to our children. Absolutely. I mean, right now we are recording this during the Covid 19 pandemic. So if you’re listening to it during that or after, it is 100% that they sense that energy. They sense that, oh, mommy, daddy or whoever is just not in a, you know, in a in a calm state.

 

00;32;28;27 – 00;32;45;02

Dr. Mona

And if you as an adult are afraid of the dentist, afraid of the doctor or whoever it may be, that child is going to pick up on it. And you said that you know, that fear that when you’re driving to that place, you’re already causing yourself to be in dread, that, oh my gosh, my child’s going to throw a tantrum.

 

00;32;45;02 – 00;33;02;11

Dr. Mona

It’s going to be awful. Don’t think that like think that it’s going to be this awesome experience because, you know, one thing that I think a lot of parents are losing is that going to the doctor or going to the dentist, these are all needed things that should not be a threat. It should not be a, well, you misbehaved.

 

00;33;02;11 – 00;33;16;18

Dr. Mona

I’m going to take you to the pediatrician and they’re going to give you a shot. I’m going to take you to the dentist, and they’re going to give you the numbing gas like that. We should not be looked at as a threatening figure. We should be looked at as this figure that’s helping your children. We’re the help. We’re helpers.

 

00;33;16;18 – 00;33;32;19

Dr. Mona

Right. And I, I see that, you know, and in the office, it’ll be like, well, you know, if you don’t, if you don’t behave, the doctor’s going to do this. And I’m like, no, no. And I actually call parents out because I’m like, no, no, no, please don’t make us the bad guy. No one has to be a bad guy in this situation.

 

00;33;32;22 – 00;33;51;26

Dr. Mona

There’s other ways to discipline a child and threats that just create the sort of fear that I don’t want to go to this lady or this guy because they’re going to give me this needle or give me this procedure. And that’s terrifying to a kid, because that’s not what we’re here for. We’re here to help you. If your tooth falls out, if you’re sick, if you, you know, to keep you healthy with vaccines.

 

00;33;51;26 – 00;34;03;13

Dr. Mona

So I, I’m, you know, I know this is obviously not dental help, but this is just how a parent can help their kid be better in the medical system. You know, because eventually they’re going to have to go and do it alone. Yeah.

 

00;34;03;16 – 00;34;22;25

Dr. Erin Isaac

Exactly. Because here’s the thing. You said, the thing about, we go to the doctor is going to give you a shot. I hear so many times, be good or you better brush your teeth or you’re going to get them all out. So then what happens? Or like, be good and brush your teeth, or you’re going to get tens of thousands of cavities and you’re going to have to get a shot and get them all.

 

00;34;22;25 – 00;34;40;19

Dr. Erin Isaac

Brilliant. So then what happens if they do get a cavity and they need to get a fill? Now they’re freaking out because you once told, is a terrible thing and it’s going to be awful. And that just doesn’t set them up for success. And like you said, in life in general, that doesn’t set them up right.

 

00;34;40;21 – 00;34;49;01

Dr. Erin Isaac

So, we have to be really, choosy. And the words that we use, you saying, positive words to somebody.

 

00;34;49;03 – 00;35;04;15

Dr. Mona

And I think, you know, scare tactics are very I mean, I know a lot of parents who do scare tactics, you know, because one time they just want the the behavior to end. So they’re like, okay, just if you don’t do this, just, you know, stop talking. Did it. And also the parents kind of scared to even away.

 

00;35;04;15 – 00;35;21;17

Dr. Mona

Right. Like you said, they’re fearful. So, you know, I, I mean, again, I, I can attest to that. Like when I go to obviously Ryan’s two month visit or vaccine appointment, I obviously am not terrified. I know what to expect. And I know, you know, obviously I’m a pediatrician, so of course I know, but I don’t react in any way.

 

00;35;21;22 – 00;35;31;29

Dr. Mona

I just go in and everyone’s like, wow, he’s so calm. I’m like, it’s because mama is calm. It’s because I’m not panicking because I know it’s a necessity. I know that it’s.

 

00;35;31;29 – 00;35;32;12

Dr. Erin Isaac

That.

 

00;35;32;17 – 00;35;49;17

Dr. Mona

The the best interest of a child, whether it’s at the dentist or the doctor, that we’re doing this to help. And I think that sort of mentality needs to come out more in parenting because we there is that fear and that sort of, well, oh my, I don’t want to, you know, I don’t want to be the bad guy and I don’t want my kid to be upset.

 

00;35;49;17 – 00;35;55;11

Dr. Mona

And look, everyone, they’re going to be upset whether we’re we do everything they want or not. The reality.

 

00;35;55;16 – 00;35;57;07

Dr. Erin Isaac

Exactly like that’s like.

 

00;35;57;07 – 00;36;13;16

Dr. Mona

Giving up that book that you give a mouse a cookie, right? Like they’re going to keep wanting something. Yeah. So we have to set loving boundaries. And I you know, I know we’re getting into parenting, but I really think it’s important on a dental talk to talk about it because so much of dental health has to do with parenting brushing.

 

00;36;13;22 – 00;36;14;23

Dr. Erin Isaac

Exactly.

 

00;36;14;23 – 00;36;19;22

Dr. Mona

Going to these visit, it’s not just like, oh, easy breezy. It’s takes time.

 

00;36;19;24 – 00;36;42;01

Dr. Erin Isaac

Exactly. And that’s the thing. Like, people ask all the time, how do you do pediatric industry? I’m like, the kids are great. It’s the parents for the, for all that might have is, you know, it’s just it’s something that we have to know that this has to be done. Like you said. And, we have to have that positivity going in.

 

00;36;43;00 – 00;37;02;17

Dr. Erin Isaac

So many times, I have parents who get on my cry, which. Listen, guys, they might cry during their first visit or little. They don’t really understand who this new person is. What’s going on? That’s okay. I mean, toddlers cry when they do anything that they don’t want to do, so it might happen and they’re going to be okay.

 

00;37;02;17 – 00;37;30;29

Dr. Erin Isaac

Like that’s just their response to doing something that they don’t necessarily want to do at that minute. That’s what we have to do. And I have so many parents will say, I’m so sorry. I’m so sorry, but what are you sorry about? You’re you’re helping your kid be healthy. You’re setting them up for future success. So that’s going to be sorry about it’s, again, choosing those words and knowing that, we talked about this before, that things aren’t always going to be picture perfect.

 

00;37;30;29 – 00;37;59;22

Dr. Erin Isaac

We’re in this society where, you know, Johnny went to his first. It was perfect. Let me put it on Instagram, which is great to show, you know, friends and family that great. He did awesome. But you don’t have to compare yourself to that. If you’re another parent who is expecting to have your child do perfect and not one little tier and they’re one year old, then, you know, that might be an issue.

 

00;37;59;22 – 00;38;13;00

Dr. Erin Isaac

You want to go in with that positivity, but know that things might happen where they might squirm, they might have a little tear roll down there and they are okay. You have to know that you’re doing everything in their best interest.

 

00;38;13;02 – 00;38;31;14

Dr. Mona

Oh yeah, I mean that. And you said that, you know, you have families come in and apologize. I get that too. And it’s like I always say, why are you apologizing? This is normal, I think. Right. And you said that probably perfectly, that the fact that people see you on social media or their friends who always want to talk about the good people, rarely talk about what’s really happening.

 

00;38;31;14 – 00;38;39;02

Dr. Mona

Right. And as a pediatrician, I can tell you that not all toddlers are angels, and it’s normal. And it’s not.

 

00;38;39;04 – 00;38;39;18

Dr. Erin Isaac

Like, okay.

 

00;38;39;19 – 00;38;59;04

Dr. Mona

Exactly. It’s not going to want to come to the doctor all the time. Like and so like that tells you that. Yeah, my kid was perfect. Okay. Yeah. That’s awesome. But yes, it is the norm and common. What’s not normal is that a family has a sort of reaction with the kid, and then they don’t work on ways to improve it for next time or the future.

 

00;38;59;07 – 00;39;16;12

Dr. Mona

I don’t care if your child loses their mind 1 or 2 times, three times, but if you just let that behavior go and say, okay, this is what it’s going to be, that’s different. But if you are actually modeling and trying, oh my gosh, that’s all we need. A parent that tries, that’s all I want. That’s all.

 

00;39;16;12 – 00;39;37;18

Dr. Erin Isaac

Exactly. And that’s exactly oh man. It’s true. I know ideally if that were to happen in the office that they don’t have a great visit. But let’s be honest, it happens. You know, the biggest thing is going home and making a positive out of it. Like, hey, here’s what Doctor Aaron said. We can work on making a positive.

 

00;39;37;18 – 00;39;54;22

Dr. Erin Isaac

And you wouldn’t be surprised how many kids are so excited the next time to show how much they’ve grown and how much of a big girl or a big boy they are. They are so excited to show that they can do it. And that makes them happy that they’re, you know, brave and strong and then that makes you happy.

 

00;39;54;22 – 00;40;17;20

Dr. Erin Isaac

And it’s great. The like you said, I think the toughest part is just letting it continue and not necessarily working on working both with the actual dental brushing and, certain behaviors too. But that’s a whole other whole nother story. But, the biggest thing is working on what can be improved.

 

00;40;17;23 – 00;40;33;06

Dr. Mona

Awesome. No, it’s it’s so, so important because I want these kids to have good habits from the beginning, not be afraid and love coming to the den. I love going to the dentist. I love going to the doctor. And it’s because I had a mother was like, this is what we’re going to do. It’s a fun.

 

00;40;33;06 – 00;40;33;20

Dr. Erin Isaac

Exactly.

 

00;40;33;22 – 00;40;40;25

Dr. Mona

And you know, we give stickers. I’m not sure if you give any sort of thing, but, you know, probably not candy, but but yes.

 

00;40;40;28 – 00;40;43;25

Dr. Erin Isaac

Oh, sugar free lollipops for sure.

 

00;40;43;28 – 00;40;54;13

Dr. Mona

But again, thank you so much for joining us on the call. Is there anything else you wanted to add before, you know, closing statements, closing advice for any, you know, obviously anyone who’s listening right now.

 

00;40;54;25 – 00;41;16;12

Dr. Erin Isaac

I would say if you’re in search of a pediatric dentist, I think thing you can do is grab a few names that you’re interested in in your area and just give them a call, see if they allow you to come in. For we call it like a visit where you can literally schedule a time for the kids to come in and just tour the office, play in the play area.

 

00;41;17;04 – 00;41;42;17

Dr. Erin Isaac

Not, necessarily like pick up the instruments and stuff like up in the area where they get their teeth cleaned, then, see the people who work there. So and when they do actually come in for their visit, I come to this place. It’s not too bad. And I would also say try to you can gauge, what type of office might fit your child’s personality better.

 

00;41;42;17 – 00;42;11;04

Dr. Erin Isaac

Like I said, my office is more boutique, so we have. So I, actually just sent me a video of a kiddo from last week or two weeks ago who came in, who dad recorded at breakfast. Like, we’re going to see doctor and and she was like, oh, like so excited. But like you that can happen as we all the things we talked about, but also finding the right fit for you in it, you know, I think there’s sort of due to climate, they’re out there, so you can definitely find it.

 

00;42;11;22 – 00;42;29;03

Dr. Erin Isaac

But just gauge, ask your friends, you know, you can go based on, Yelp reviews and things like that, too, but ask your friends and your family, they take their kids to, and you’ll find that at some kids, you just find in the offices that are tons and tons of kids, you know, running around. That’s not our office.

 

00;42;29;03 – 00;42;41;00

Dr. Erin Isaac

That’s not the vibe that I wanted in my office. So there’s a certain type of parent and patient that comes into my office, and it works out perfect. So book an office that’s right for you.

 

00;42;41;03 – 00;43;07;28

Dr. Mona

That is great advice. Thank you. And again, if if you are interested in more about pediatric dental health, even if you’re not, by the way, because she’s just awesome. You should follow her. Doctor Dr. underscore in on Instagram and. Yep. Aaron, doctor Aaron and I, we actually met in person, so I can attest to the fact that not only is she awesome on Instagram, but she’s awesome in real life, which is even more amazing to follow someone that you can vouch for.

 

00;43;07;28 – 00;43;19;27

Dr. Mona

So I, I loved having this conversation with you. I’m sure we’ll have tons more on podcast episodes and then off of yes, so let’s do that thing. You know, thank you for being here.

 

00;43;20;00 – 00;43;23;07

Dr. Erin Isaac

Absolutely. Thank you for having me. And this was so fun.

 

00;43;23;10 – 00;43;42;29

Dr. Mona

Thank you for tuning in for this week’s episode. I hope you guys enjoyed it. As always, please leave a review, share it with a friend, comment on my social media. And if you’re not already, follow me at PedsDocTalk on Instagram. I love doing this for all of you. Have a great rest of your week. Take care. Talk to you soon!